Provider Demographics
NPI:1982229233
Name:DAVIS, LILLIAN S
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:S
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 E FRANKLIN ST STE 1200B
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5838
Mailing Address - Country:US
Mailing Address - Phone:910-725-6331
Mailing Address - Fax:
Practice Address - Street 1:1829 E FRANKLIN ST STE 1200B
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5838
Practice Address - Country:US
Practice Address - Phone:910-725-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0234241041C0700X
NCC0160881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical